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Wilson's Solution (Gentamicin Sulfate)

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  • Wilson's Solution (Gentamicin Sulfate)

    I'm currently taking 875mg Augmentin twice a day along with Bactroban Nasal to treat a chronic sinus infection. This is the second time I'm following this protocol in a 6-month period and my ENT would like to try something else, should the infection recur (which he believes is likely). He is concerned about the potential effects that levofloxacin could have on my baby's joints, despite the information in LactMed suggesting that it would be acceptable option if I delayed feeding for 4-6 hours after taking the medication.

    He would like to prescribe intranasal irrigation with Wilson's Solution (Gentamicin sulfate), but is concerned about potential systemic effects in my 5-month old baby. My doctor specifically mentioned tobramycin as the active ingredient in the solution and I've read that tobramycin is poorly excreted into milk and poorly absorbed orally by the infant, making it an acceptable choice. However the studies cited in LacMed mention intravenous injections and ear/eye drops - not intransal irrigation - and I'm not sure whether the distribution changes when the medication is given intranasally. Would tobromycin continue to "present little or no risk of systemic effects" when applied intranasally?

  • #2

    Tobramycin even when given IM or IV has very low transfer into the breast milk, only 2.6% of your dose. When used as an intranasal irrigation if may have slightly more absorption than in the eye or ear, but still not enough to put your infant at risk as it has very poor oral bioavailability, any passed into the milk would not likely be absorbed by the infant. It should still be ok to breastfeed after using the tobramycin (Wilsons Solution).

    Sandra Lovato R.N.
    InfantRisk Center